Folliculitis: Symptoms, Treatment, and When to Seek Help

I'm not sure if it's folliculitis?

Hello doctor, two nights ago I noticed a small bump on the back of my right thigh that was neither painful nor itchy, so I didn't pay much attention to it.
However, last night I found that the small bump had turned into a white pus-filled lesion (about the size of a small pimple) and was slightly painful to touch.
This morning, the lesion had doubled in size, with a red halo around it.
When I went to the clinic, the doctor applied medication, and the lesion ruptured on its own.
The doctor suggested it was likely folliculitis and prescribed an ointment, but did not prescribe any oral medication.
Tonight, while applying the ointment, I noticed that a small pus-filled lesion has reappeared at the wound site, and it is painful.
Additionally, my right leg feels easily fatigued, and I experience a sharp cold sensation when exposed to cool air.
Could this be folliculitis? Should I go back to the clinic to have the new pus-filled lesion drained? Thank you for your help.

Ms. Huang, 20~29 year old female. Ask Date: 2016/09/10

Dr. Wu Yuxin reply Dermatology

Without actually seeing the lesion, it is impossible to make a definitive diagnosis.
If it is causing significant distress, please seek medical attention as soon as possible.

Reply Date: 2016/09/10

More Info

Folliculitis is an inflammation of the hair follicles, often caused by bacterial or fungal infections. It can manifest as small, red bumps or white-headed pimples around hair follicles, which can be itchy or painful. In your case, the symptoms you've described—such as the development of a small bump that turned into a white pus-filled lesion, along with redness and mild pain—are indeed consistent with folliculitis.

Symptoms of Folliculitis
The symptoms of folliculitis can vary but typically include:
- Small red bumps or white-headed pimples at the site of hair follicles.

- Itching or tenderness in the affected area.

- In some cases, the bumps may become larger and form pus-filled lesions.

- Surrounding skin may appear red and inflamed.

Treatment Options
Treatment for folliculitis often depends on the severity and underlying cause. Here are some common approaches:
1. Topical Antibiotics: Since your doctor prescribed a topical ointment, it is likely an antibiotic cream designed to combat any bacterial infection. It's essential to apply it as directed.

2. Oral Antibiotics: If the condition worsens or does not improve with topical treatment, oral antibiotics may be necessary, especially if there is a significant bacterial infection.

3. Warm Compresses: Applying warm compresses to the affected area can help soothe discomfort and promote drainage if there is a pus-filled lesion.

4. Avoiding Irritants: Avoid tight clothing and harsh skin products that may irritate the area. Keeping the area clean and dry is also crucial.

5. Antifungal Treatments: If a fungal infection is suspected, antifungal creams or medications may be prescribed.

When to Seek Help
You should consider seeking medical attention if:
- The lesions continue to multiply or worsen despite treatment.

- You experience increased pain, swelling, or fever, which may indicate a more severe infection.

- The area becomes increasingly red or warm, suggesting that the infection is spreading.

- You have underlying health conditions that may complicate the infection, such as diabetes or a weakened immune system.

Regarding Your Current Situation
Given that you have noticed new pus-filled bumps and are experiencing pain, it is advisable to consult your doctor again. While it may be tempting to pop or drain the new bumps yourself, this can lead to further irritation or infection. A healthcare professional can assess the situation and determine whether drainage is necessary or if a different treatment approach is warranted.

The sensation of coldness and muscle soreness in your leg could be related to inflammation or irritation in the area, but it is essential to discuss these symptoms with your healthcare provider to rule out any other underlying issues.

In summary, your symptoms align with folliculitis, and while topical treatment is a good first step, monitoring the situation closely and consulting your doctor for any worsening symptoms is crucial. Proper care and attention can help ensure a swift recovery.

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